Farquharson Barbara, Dombrowski Stephan, Pollock Alex, Johnston Marie, Treweek Shaun, Williams Brian, Smith Karen, Dougall Nadine, Jones Claire, Pringle Stuart
Nursing, Midwifery and Allied Health Professionals Research Unit , University of Stirling , Stirling , UK.
School of Psychology, University of Stirling , Stirling , UK.
Open Heart. 2014 Aug 12;1(1):e000079. doi: 10.1136/openhrt-2014-000079. eCollection 2014.
Delay to presentation with symptoms of acute coronary syndrome (ACS) is common meaning many fail to achieve optimal benefit from treatments. Interventions have had variable success in reducing delay. Evidence suggests inclusion of behaviour change techniques (BCTs) may improve effectiveness of interventions but this has not yet been systematically evaluated. Data from other time-critical conditions may be relevant.
A systematic review will be undertaken to identify which BCTs are associated with effective interventions to reduce patient delay (or prompt rapid help-seeking) among people with time-critical conditions (eg, chest pain, ACS, lumps, stroke, cancer and meningitis). A systematic search of a wide range of databases (including Cochrane Library, MEDLINE, EMBASE, CINAHL, PsycInfo) and grey literature will be undertaken to identify all relevant intervention studies (randomised controlled trials, controlled clinical trials and cohort studies). Two independent reviewers will screen abstracts to identify relevant studies, apply inclusion criteria to full papers, assess methodological quality and extract data.
Change in patient decision time BCTs reported in each of the included studies will be categorised and presented according to the latest reliable taxonomy. Results of included studies will be synthesised, exploring relationships between inclusion of each BCT and effectiveness of the overall intervention. Where possible, means and SDs for differences in delay time will be calculated and combined within meta-analyses to derive a standardised mean difference and 95% CI. Analysis of (1) all time-critical and (2) ACS-only interventions will be undertaken.
No ethical issues are anticipated. Results will be submitted for publication in a relevant peer-reviewed journal.
急性冠状动脉综合征（ACS）患者出现症状后延迟就诊的情况很常见，这意味着许多人无法从治疗中获得最佳益处。在减少延迟方面，干预措施取得的成效各异。有证据表明，纳入行为改变技术（BCTs）可能会提高干预措施的有效性，但尚未对此进行系统评估。来自其他时间紧迫病症的数据可能具有相关性。
将进行一项系统综述，以确定哪些行为改变技术与有效干预措施相关，这些干预措施可减少时间紧迫病症（如胸痛、急性冠状动脉综合征、肿块、中风、癌症和脑膜炎）患者的延迟就诊时间（或促使其迅速寻求帮助）。将对广泛的数据库（包括Cochrane图书馆、MEDLINE、EMBASE、CINAHL、PsycInfo）和灰色文献进行系统检索，以识别所有相关的干预研究（随机对照试验、对照临床试验和队列研究）。两名独立的评审员将筛选摘要以识别相关研究，对全文应用纳入标准，评估方法学质量并提取数据。
纳入的每项研究中报告的患者决策时间行为改变技术将根据最新可靠分类法进行分类和呈现。将综合纳入研究的结果，探讨每种行为改变技术的纳入与总体干预效果之间的关系。在可能的情况下，将计算延迟时间差异的均值和标准差，并在荟萃分析中进行合并，以得出标准化均值差异和95%置信区间。将对（1）所有时间紧迫病症和（2）仅针对急性冠状动脉综合征的干预措施进行分析。
预计不存在伦理问题。研究结果将提交至相关同行评审期刊发表。
